Scientific American columns

Attachment therapy is based on a pseudoscientific theory that, when put into practice, can be deadly

In April 2000, 10-year-old Candace Newmaker began treatment for attachment disorder. Her adoptive mother of four years, Jeane Newmaker, was having trouble handling what she considered to be Candace’s disciplinary problems. She sought help from a therapist affiliated with the Association for Treatment and Training in the Attachment of Children and was told that Candace needed attachment therapy (AT), based on the theory that if a normal attachment is not formed during the first two years, attachment can be done later.

According to the theory, the child must be subjected to physical “confrontation” and “restraint” to release repressed abandonment anger. The process is repeated until the child is exhausted and emotionally reduced to an “infantile” state. Then the parents cradle, rock and bottle-feed him, implementing an “attachment.”

Candace was treated by Connell Watkins, a nationally prominent attachment therapist and past clinical director for the Attachment Center at Evergreen (ACE) in Colorado, and her associate Julie Ponder. The treatmentwas carried out in Watkins’s home and videotaped. According to trial transcripts, Watkins and Ponder conducted more than four days of “holding therapies.” On one day they grabbed or covered Candace’s face 138 times, shook or bounced her head 392 times and shouted into her face 133 times. When these actions failed to break her, they put the 68-pound Candace inside a flannel sheet and covered her with sofa pillows, while several adults (with a combined weight of nearly 700 pounds) lay on top of her so that she could be “reborn.” Ponder is reported to have told the girl to imagine that she was “a teeny little baby” in the womb, commanding her to “come out head first.” In response, Candace screamed, “I can’t breathe, I can’t do it! … Somebody’s on top of me … I want to die now! Please! Air!”

According to AT, Candace’s reaction was a sign of her emotional resistance, calling for more confrontation to achieve emotional healing. ACE (now operating as the Institute for Attachment and Child Development) claims that “confrontation is sometimes necessary to break through a child’s defenses and reach the hurting child within.” Putting theory into practice, Ponder admonished, “You’re gonna die.” The girl begged: “Please, please, I can’t breathe.” She then vomited and cried, “I gotta poop.” Ponder instructed the others to “press more on top,” on the premise that such children exaggerate their distress. Her mother entreated, “I know it’s hard, but I’m waiting for you.”

After 40 minutes of struggling, Candace went silent. Ponder rebuked her: “Quitter, quitter!” Someone joked about performing a C-section, while Ponder patted a dog that meandered by. After 30 minutes of silence, Watkins remarked, “Let’s look at this twerp and see what’s going on. Is there a kid in there somewhere? There you are lying in your own vomit. Aren’t you tired?”

Candace wasn’t tired; she was dead. The death certificate listed the proximate cause as asphyxiation, and her therapists received the minimum sentence of 16 years for “reckless child abuse resulting in death.” The ultimate cause was pseudoscientific quackery masquerading as psychological science. “However bizarre or idiosyncratic these treatments appear — and however ineffective or harmful they may be to children — they emerge from a complex internal logic based, unfortunately, on faulty premises,” write Jean Mercer, a psychologist at Richard Stockton College of New Jersey, and Larry Sarner and Linda Rosa of the National Council against Health Fraud in their 2003 analysis, Attachment Therapy on Trial: The Torture and Death of Candace Newmaker.

Other children have died after AT as well. The American Psychiatric Association states: “While some therapists have advocated the use of so-called coercive holding therapies and/or ‘re-birthing techniques,’ there is no scientific evidence to support the effectiveness of such interventions.” Nevertheless, AT continues to flourish. ATTACh claims to have about 600 members. The numbers may be even higher, Mercer, Sarner and Rosa say, because the practice goes by different labels, including holding-nurturing process, rage reduction, cuddle time and compression therapy (see www.ChildrenInTherapy.org).

By whatever name, AT remains a pseudoscience. We should ban its practice before it tortures and kills children again.